Anna Charlotte Chupp

Individual provider Active NPI Counselor · Fort Valley, GA

NPI 1720715865 · NPPES record last updated Aug 8, 2022

Key facts

NPI
1720715865
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
410 E Church St
Fort Valley, GA 31030-3097
Phone
(229) 815-5454
NPI assigned
Aug 8, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X GA Yes

Addresses

Primary practice location

410 E Church St
Fort Valley, GA 31030-3097

Mailing address

122 W Forsyth St
Americus, GA 31709-3561
Phone (229) 815-5454

Electronic endpoints

TypeEndpointUseAffiliation
Other URL NA Other

Other providers in Fort Valley, GA

All providers in Fort Valley, GA · Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.